Hysterectomy Surgery
Many women experience pelvic pain and abnormal bleeding because of fibroids, ovarian cysts, endometriosis and other conditions. There are many ways to treat these gynecological problems, including hysterectomy.
Hysterectomy is one of the most frequently performed major surgeries among reproductive-age women. The procedure to remove the uterus and cervix can be performed to treat an array of reproductive-related conditions.
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What Happens During a Hysterectomy?
The hysterectomy surgery removes the uterus and cervix. The surgeon may also remove one or both ovaries and fallopian tubes. If you have not yet reached menopause, a hysterectomy means you will no longer have a period or be able to get pregnant. Hysterectomy surgery is performed under general anesthesia, meaning the patient will be asleep during surgery.
Reasons for Hysterectomy
There are a number of conditions that can be addressed with hysterectomy surgery. These include:
- Abnormal uterine bleeding
- Chronic pelvic conditions, including pelvic pain or pelvic inflammatory disease
- Chronic pelvic pain
- Dysmenorrhea (painful periods)
- Endometriosis
- Gender affirmation for transgender and non-binary individuals
- Gynecologic cancer
- Heavy menstrual bleeding
- Uterine fibroids
- Uterine prolapse
Hysterectomy Types
The uterus is always removed during a hysterectomy. In some cases, surgeons may also need to remove one or both ovaries, the fallopian tubes or other parts of the reproductive system. Your gynecologist will discuss the best type of hysterectomy for you. Some of the types of hysterectomy include:
- Total hysterectomy: This is the most common type of hysterectomy. The gynecologic surgeon removes the whole uterus including the cervix, but not the fallopian tubes or ovaries.
- Total hysterectomy with bilateral salpingo-oophorectomy: Removes the uterus, cervix, and both ovaries and fallopian tubes.
- Supracervical hysterectomy: Also called subtotal or partial hysterectomy, the surgeon removes the body of the uterus while leaving the cervix whole.
- Radical hysterectomy: Removal of the uterus, cervix and the top part of the vagina. The pelvic lymph nodes may also be removed for women with cancer.
- Radical hysterectomy with bilateral salpingo-oophorectomy: Often used to treat endometrial cancer, this procedure removes the uterus, cervix and both ovaries and fallopian tubes.
Hysterectomy Methods
If your gynecologist recommends a hysterectomy, it’s important that you learn about the range of surgical options. Your doctor will talk with you about the best method for your hysterectomy based on your personal needs and goals.
University Hospitals offers advanced minimally invasive surgery for hysterectomy. This type of surgery involves smaller incisions with reduced risk of blood loss and scarring, less pain, and faster recovery time than traditional open surgery.
- Da Vinci Robotic-Assisted Hysterectomy
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A robotic hysterectomy at UH, using the da Vinci surgical system, involves a few small incisions through which all of the surgical instruments are inserted. This technology gives surgeons a 3-D, high definition view of the surgical field and greater surgical precision and range of motion. Da Vinci robotic hysterectomy surgery offers many benefits to patients compared to traditional hysterectomy, such as faster recovery and return to daily activities, less scarring, less pain and lower risk of complications.
- Laparoscopic Hysterectomy
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A laparoscope – which is a thin, flexible tube with a video camera on it – is inserted through tiny incisions near the belly button, then the uterus is removed in sections through the laparoscope tube or vagina.
- Vaginal Hysterectomy
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With this approach, the gynecologic surgeon removes the uterus through the vaginal opening. This technique is most often used for uterine prolapse, or when vaginal repairs are needed. No incision is needed. This means there is no visible scarring, and many women can go home the same day or the next morning.
Frequently Asked Questions
- How long does hysterectomy recovery take?
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Once you have been discharged from the hospital, you will need to rest and keep any incisions clean and dry. Avoid strenuous activity, intercourse and lifting heavy objects. Your doctor will let you know when you can resume normal activities such as work, exercise and sexual intercourse.
Recovery can take anywhere from two up to 12 weeks, depending on the type of surgery you have.
- How long does hysterectomy surgery take?
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Hysterectomy surgery can take between one and four hours. The duration of surgery depends on the type of procedure you have and how it is performed.
- What are the risks of hysterectomy?
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Hysterectomy is generally a safe procedure with excellent success rates. However, there are some potential risks and complications. These include early menopause, excessive bleeding, blood clots, injury to surrounding organs(e.g., bladder or kidneys), urinary incontinence, scar tissue formation, pain and infection.
- Are there alternatives to a hysterectomy?
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Depending on the specific condition, there may be other treatment options that can be attempted before hysterectomy, including medications or other procedures. This option is beneficial for pre-menopausal women who want to preserve their fertility. In some cases, women may choose to delay hysterectomy surgery until they are done having children.